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There are a number of plastic surgical procedures that do not require surgical incisions to achieve a cosmetic benefit. Dr. Weeter may
recommend several types of injectable wrinkle reducers, wrinkle fillers, fat grafting by injection, laser treatments for skin improvements,
and skin care products.

The wrinkle reducer injections block the nerve impulses that cause the muscle contractions responsible for creating expression
lines on the face. These anti-aging injectable medications can weaken those muscles of expression, which then reduce the lines of expressions
that created some wrinkles, folds or furrows. There are currently two FDA approved Botulinum Type A medications which can relax these muscles
that cause the expression lines responsible for some wrinkling. These injectables are BOTOX® Cosmetic and Dysport. Commonly injected sites include
the mid- and lower face, and the glabella, which is the area between the eyebrows responsible for "frown lines". BOTOX® Cosmetic and Dysport
are also commonly injected in the forehead region, at the outer corners of the eyes (crow's feet), on either side of the mid-chin (to treat a
down-turned mouth), and in the neck (to treat neck bands or visible chords).

The wrinkle fillers are substances injected in the lower layer of the skin or just beneath the skin into underlying soft tissues.
Their purpose is to fill out facial wrinkles, creases and depressed scars. They can also be used to fill out and enhance the facial contours for an
improved aesthetic or cosmetic appearance-one usually associated with youth or beauty.

Some of the most commonly injected facial rejuvenation fillers are Restylane, Juvéderm, and Radiesse. Commonly injected sites are around the
mouth and cheeks, such as the naso-labial fold that extends from the nose toward the corner of the mouth. Other areas that may benefit from injectable
fillers can smooth out creases and signs of aging in the middle to lower face as well as the chin and jawline. Radiesse has an additional indication to provide some volume and lift in the area of the cheekbones and cheeks which have diminished or settled with aging. More information about Radiesse, which explains how it works and shows real patient's results, can be seen at Radiesse.com

Fat grafting by injection can harvest small amounts of fat from elsewhere on the patient and implant it to augment areas that have
lost a youthful contour.

BOTOX® Cosmetic and Dysport injections are used to smooth out wrinkles caused by the activity of the muscles of facial expression.
Wrinkles are caused by both the activity of the muscles of facial expression and by loose skin. Loosening of the skin is a consequence of
the aging process, sun (and UV light in tanning beds), and cigarette smoking. As the skin loosens, muscle contraction causes wrinkles and furrows.
When these are injected into specific muscles, they cause a temporary paralysis of these facial muscles so that they cannot contract and
cause the wrinkles. Another use is to weaken the depressor muscles below the lateral eyebrow, which permits the muscles above the eyebrow
give a lift that may last a number of months.

BOTOX® Cosmetic and Dysport treatments are becoming increasingly more popular for several reasons. The treatment is effective and
lasts about 6 months. It is less costly than surgical procedures. There is little or no down time for healing or follow-up care, such as
suture removal. Patients can return to work or face the public after treatment. Some candidates for removal of frown lines may wish to have
a temporary correction with Botox prior to committing to a permanent improvement with a
forehead/brow lift.

WHO IS A CANDIDATE

Patients that have dynamic wrinkles, which are caused by muscle function.

The most commonly treated areas are frown lines between the eyebrows, horizontal forehead creases, mild drooping of the eyebrows,
"crow's feet," and wrinkles around the mouth. Muscle bands from the chin to the neck may also be treated.

Patients who wish to see the benefit of a lateral eyebrow lift.

OTHER USES OF BOTOX® COSMETIC & DYSPORT

BOTOX® can also help treat excessive sweating of the hands and axillae.

BOTOX® injections may also be beneficial for treatment of migraine headaches.

PROCEDURE DESCRIPTION

The patient identifies the area to be treated. The patient contracts the muscle that causes the wrinkling to define the muscle to be treated.
The BOTOX® Cosmetic or Dysport are injected into the muscle. The benefits of the treatment become evident over several days.

Laser Resurfacing and Chemical Resurfacing Peels

Laser rejuvenation of one's facial skin can improve the complexion of the skin's color, texture, and vascularity, as well as tighten
it to decrease wrinkling. Chemical peels and modern laser resurfacing are useful procedures that do not require surgical incisions.
Dr. Weeter uses several types of lasers or peels for specific types of improvement. The CO2 laser reduces wrinkles, tightens the skin,
and helps re-establish a more uniform complexion. It may also remove some sun damaged, and possibly pre-malignant, skin conditions.
A special laser for vascular conditions can diminish prominent blood vessels of areas such as the cheeks and around the nose.
Other lasers can treat "sun spots."

WHO IS A CANDIDATE

Patients whose facial skin has poor texture or dark, irregular pigmentation due to sun damage or with rough, dry patches.

Facial rejuvenation patients who have facial wrinkles and loss of skin elasticity. These wrinkles may be of the dynamic type caused by muscles, such as around the mouth, or the static type, such as seen in the cheeks.

Laser resurfacing is particularly effective for the wrinkles above the lip. Some women refer to these as "lipstick lines."

Patients who have acne scarring.

Patients with prominent superficial blood vessels of the skin that some people call "broken capillaries."

INTENDED RESULT

More youthful look.

Improved skin texture and elasticity with more homogeneous pigmentation and a smoother surface.

Improved wrinkles.

Restoration of sun damaged skin changes.

Diminished acne scars.

Decreased prominence of small blood vessels seen just beneath the skin.

PROCEDURE DESCRIPTION

Laser resurfacing is done with a CO2 laser with either local anesthesia with sedation, or general anesthesia.

Resurfacing may be done to the entire face or to specific areas such as the periorbital region (around the eyes) or the perioral region (around the mouth).

A special post-laser surgical dressing is used for up to a week to minimize discomfort, absorb drainage, and promote healing.

Other, non-resurfacing lasers may be used specifically to remove prominent blood vessels or to diminish darkly pigmented spots. These are commonly done in the office and require little or no down time. These may not require anesthesia.

RECUPERATION AND HEALING

An occlusive membrane or dressing will be applied immediately after your resurfacing procedure that will stay on for several days. After the membrane or dressing is removed, you will be given an ointment to be applied twice daily until the skin heals.

The skin is red and weepy for 5 to 7 days, after which it will be red like a sunburn. The redness will diminish from a sunburn-red to a mild red or chapped look to pink over a variable period of time lasting from one to three months. After the skin is healed but still red, you may apply camouflaging makeup, if desired.

Initial discomfort subsides rapidly and can be controlled with oral medication.

Sun block will be necessary to protect your newly resurfaced skin from further sun damage.

Laser removal of prominent blood vessels or pigment spots needs no dressing because the skin surface does not weep. Usually makeup can be applied soon thereafter.

Wrinkles and Soft Tissue Fillers

Like BOTOX® Cosmetic and Dysport, the use of various wrinkle and soft tissue contour fillers is an office procedure.

There are a number of new injectable filler products that improve and reshape the contours of the face and the skin's wrinkling to help rejuvenate. They restore volume loss to improve contours or plump up areas that have lost their youthful shape. They can fill in and stretch out wrinkles as well. Some of the best know include Restylane, Radiesse, Juvéderm, and Captique. Doctor Weeter injects them as office procedures to restore volume loss from the aging process to temporarily smooth out facial lines and wrinkles. Examples of areas that can be treated include: frown lines between the eyebrows, prominent naso-labial folds between the cheek and lips, vertical lip lines, and the hollowed depression in front of the jowls.

Skin Care Products

Skin care products compliment the benefit of both the surgical procedures and the non-surgical (non-invasive) to achieve a more youthful skin. These physicians prescribed skin care products were developed to refine and restore the complexion of the skin at the cellular level. They can help correct sun damaged changes and help prevent further UV damage. Doctor Weeter recommends prescription strength ingredients that are not available over the counter. Some of the products available include the OBAGI Nu-Derm System, Dermesse products, Kinerase, and other fine products. The benefits found are a more healthy and youthful skin that is smoother with fewer fine lines and wrinkles, less roughness, firmer, and loss of age and sun-related brown spots.

NOTE: The specific risks and the suitability of this procedure for you may be determined only at the time of consultation. All surgical procedures have some degree of risk. All of this web site content, and any email responses to your inquiries are strictly for general informational and educational purposes. It is not medical advice and should not be taken as medical advice. It should not be used to diagnose or treat a health problem or disease. It is not meant to be a substitute for professional medical care.